Provider Demographics
NPI:1619838034
Name:TRANSFORMATIVE HEALING, PLLC
Entity type:Organization
Organization Name:TRANSFORMATIVE HEALING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOCKHOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-440-4329
Mailing Address - Street 1:418 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-3254
Mailing Address - Country:US
Mailing Address - Phone:217-897-5753
Mailing Address - Fax:
Practice Address - Street 1:418 N 24TH ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-3254
Practice Address - Country:US
Practice Address - Phone:217-897-5753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty